Horizon filed a lawsuit in U.S. District Court against the New Jersey Doctor-Patient Alliance. The 350-member group represents independent physicians and other medical professionals like chiropractors and physical therapists. Horizon claimed the group launched a “smear campaign” against the insurer after it decided to sign a contract with American Specialty Health to review claims and determine medical necessity for Horizon members.
In its criticism of the contract, the Doctor-Patient Alliance said that “there could be a steep increase in improper claim denials” due to the change, according to the New Jersey Record. The alliance called the contract “bad news” for Horizon patients and claimed “cutting benefits appears to be the business model” of American Specialty Health.
Horizon requests in its lawsuit that the alliance take down any ads and petitions opposing the contract. The insurer also wants the alliance to post “corrective advertising” and reimburse Horizon for any economic losses incurred by what it deems false and misleading advertising. The provider advocacy group rebutted, saying the lawsuit aimed to quiet free speech among its members and their patients.
Read the full report here.
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